Tetany causes the muscles and nerves to become overexcited. This can manifest itself in cramp-like motor disorders through to very painful muscle cramps, but in milder cases it can also only be a tingling sensation. Tetany usually affects either the face, in this case the facial nerve, or the arms and legs.
What is tetany?
Tetany is the hyperexcitability of nerves and muscles, which can manifest itself from slight tingling to motor disorders and very painful muscle cramps. Tetany usually affects the arms, legs or face. Both hypocalcaemic tetany and normocalcaemic tetany can be considered as causes. For what does knee osteoarthritis stand for, please visit ezhoushan.net.
In both cases, the serum calcium level in the blood falls, but for different reasons. The symptom then is a tetanic attack, mostly on the face, arms or legs, but in rare cases also in the bladder, intestines or respiratory muscles. When diagnosing tetany, it is important to find the exact cause, because only then can tetany, which is only a symptom, be treated properly.
Causes
There are several causes that produce tetany. One of the causes is hypocalcemic tetany. In this case, the serum calcium level is reduced. Reasons for this can be vitamin D deficiency, kidney weakness, pancreatitis, but also a food intolerance to gluten or a calcium absorption disorder.
Therefore, the electrical conductivity of the nerve-muscle transmission changes and the muscle cells become more excitable. Another cause is normocalcemic tetany. In this case, too much calcium is bound, so that the free serum calcium falls. Reasons for the form of tetany can be a magnesium deficiency, but also hyperventilation or a craniocerebral trauma as well as severe vomiting.
Symptoms, Ailments & Signs
The tetanic attack can be regarded as a symptom of tetany. This attack often begins with a tingling sensation in the affected area of the body. Psychological symptoms such as irritability, restlessness or even anxiety can also occur. This usually leads to the typical muscle cramps in the face, arms or legs.
The so-called fish mouth position can occur on the face. If the arms are affected, the hands are often cramped into a pawed position. If the muscle cramp occurs in the legs, the drop foot position is a typical sign of tetany. Rarely, the urinary bladder, intestines or respiratory muscles can also be affected.
Urge to urinate, diarrhea and shortness of breath are then usually the result. Most tetanic seizures last only minutes. However, such seizures can sometimes last up to several hours. In such cases, a calcium injection from a doctor usually helps.
Diagnosis & course of disease
Tetany itself is just a symptom. When diagnosing, it is important to find out the exact cause. A blood test often helps. Here the concentration of the electrolytes and calcium itself, but also of vitamin D and parathyroid hormone is determined. It can also make sense to measure kidney values to find kidney disease.
It may be necessary to investigate whether there is inflammation of the pancreas or an underactive parathyroid gland. It can also make sense to examine the patient to see whether they have a gluten intolerance. Examination of the blood gases can be used to determine whether the tetany was caused by hyperventilation.
Complications
If tetany is left untreated, serious complications can occur. As a result of the disease, the kidneys are the first to be damaged. In the worst case, organ failure or dysfunction can occur. The latter is associated with symptoms such as urinary tract infections, pain and sepsis. Other organs are also damaged in the course of a tetanic attack – there are problems with the liver, gallbladder and brain.
In the case of the brain, the disease can cause permanent damage and, along with it, lead to neurological and mental deficits. As it progresses, tetany can cause paralysis, usually associated with psychological symptoms such as anxiety disorders or depression. Ultimately, the hyperexcitability of the muscles eventually leads to unconsciousness and death of the patient.
In less severe cases, complications such as urinary urgency and incontinence and breathing difficulties occur. This can be accompanied by dehydration and deficiency symptoms which, if left untreated, can also lead to neurological deficits and other complaints. When treating tetany, the main risks come from the incorrect use of medication. Dehydrators and laxatives can make the symptoms even worse.
When should you go to the doctor?
In the event of a tetanic attack, an ambulance should be called. The first signs such as the typical tingling, restlessness or irritability should be observed and treated if possible. The patient should lie down quietly and wait for the seizure to subside. A mild seizure lasts only a few minutes. Meanwhile, the person concerned must be observed and calmed down. Sometimes there are symptoms such as shortness of breath or diarrhea that require immediate treatment. If you are short of breath, you should unbutton your top and lie down on your back.
Severe seizures can last several hours and should be treated by a doctor. The doctor can quickly alleviate the symptoms with a calcium injection. Therefore, in the case of tetany, it is best to always consult a doctor or take the person to a hospital. For repeated seizures, a doctor needs to determine the cause. You may have kidney disease or inflammation of the pancreas that needs to be treated first. Depending on the cause, the nephrologist, internist and orthopedist are also responsible in addition to the general practitioner.
Treatment & Therapy
In general, it is important in the case of tetany to find out the underlying disease and treat it accordingly. If the tetanic attack is caused by hyperventilation, having patients breathe into a plastic bag is helpful because this allows excess exhaled carbon dioxide to be returned to the bloodstream. A calcium shot is helpful for severe tetanic seizures, which can sometimes last for hours.
It is also important to know that the treatment should not involve an overdose of calcium either. If calcium or magnesium deficiency is caused by improper nutrition, nutritional advice can help. The incorrect use of medication such as diuretics or laxatives can also lead to disturbances in the electrolyte values and thus to tetany. Here, too, thorough clarification by the attending physician is required.
Prevention
In cases where the tetany is not triggered by a serious underlying disease, which must then be treated in any case, tetanic attacks can often be avoided by disturbing the electrolyte balance with an overall healthy lifestyle and diet. Vitamin D is primarily formed when people stay outside in daylight for a sufficiently long time.
Especially in the dark season, it is therefore important to use the hours when there is enough daylight for walks or sports in the great outdoors. The diet should contain enough calcium and magnesium. Anyone who eats a wholesome diet will not normally get a calcium or magnesium deficiency in their diet.
Too much alcohol has a dehydrating effect and can also pull too many electrolytes out of the body. The same goes for diuretics and laxatives. It is therefore important to be careful with drinking too much alcohol and using said medication.
Aftercare
Tetany is a spasm of the muscles. Since these muscle cramps can have various causes, the aftercare is also related to the causative disease. In principle, tetany can be caused by a lack of magnesium, but these deficiency symptoms can be caused by other diseases, such as the thyroid.
The aftercare of the tetany itself is therefore not necessary, but the treatment of the actual disease, which is usually required permanently. A special form of tetany is psychogenic tetany, which occurs in psychiatry and can cause seizures similar to epilepsy. The follow-up care is therefore always designed for the underlying disease and usually not for the tetany itself.
The acute treatment of tetany completes the necessary measures. A specialist must determine whether the patient in question requires long-term therapy with certain medications that can prevent or suppress or at least alleviate the recurrence of tetany.
Individual advice from a specialist is essential in this case. The patient should be educated and informed about how to prevent tetany. If there is a systemic underlying disease on which the tetany is based, lifelong treatment may be necessary, so that one cannot speak of pure follow-up care here.
You can do that yourself
In the case of tetany, the first thing to do is to compensate for the causal calcium deficiency. This can be achieved by changing your diet or by taking dietary supplements. In addition, the patient must take it easy, since the muscle spasm is usually extremely painful.
If the cramps are particularly intense, medication may also have to be taken. The patient should contact the doctor and record the complaints in a diary. The pain must be treated at the same time, especially in the case of persistent symptoms, such as those that can occur in normocalcaemic tetany. The causative alcolosis must be treated by bed rest and the avoidance of risk factors. The tetany should subside within a few hours.
If the symptoms persist for a longer period of time, there may be a serious illness. The patient should contact a specialist doctor who, if necessary, will arrange for a further examination of the blood count. Epilepsy-like disorders can occur with severe seizures. The first responders then have to fix the person concerned so that they do not injure themselves. It is important to calm the person concerned and, if available, to treat them with emergency medication. An examination in the hospital is then necessary.
